A weekly dose of insights, tools, and opportunities for EMDR therapists; designed to support your growth, sharpen your practice, and connect you with what's next.
EMDR Therapists at Greater Risk of Burnout?
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I’ll get straight to the point: EMDR work carries unique occupational hazards that has the potential to create burnout faster than other therapeutic modalities:
Each of these factors can create challenges that many of us weren't prepared for in training. That’s why today, I want to share some practical strategies for building a sustainable EMDR practice (that honors both your clinical effectiveness and your personal wellbeing). Why EMDR Work Hits Different The very nature of EMDR and the kind of trauma content it brings out can make it more exhausting than other forms of therapy, but it's not just the trauma stories. During an EMDR session, you're:
And because of this, your nervous system is working overtime in ways it might not during regular therapy sessions. This level of hypervigilance can create physical tension that accumulates throughout the day, often leaving you with shoulder tension, eye strain, and a particular kind of exhaustion (much more than normal work fatigue). But the physical demands are only part of the story. The emotional accumulation in EMDR work is much different from traditional therapy. While clients in regular therapy might discuss difficult emotions or challenging life events, EMDR clients are often reliving their most traumatic moments in more vivid detail than they are normally capable of (thank you, bilateral stimulation). Day after day of this intense emotional exposure can take a toll that builds over time, sometimes so gradually that we don't notice until we're already depleted. There's also time pressure. The eight-phase protocol can create internal pressure to complete processing within sessions, which can lead to appointments that feel rushed to end on time. When multiple sessions end up that way, your whole day becomes compressed and chaotic:
And of course, the bilateral stimulation component adds yet another layer of demand that's specific to EMDR work. Whether you're using eye movements, tactile stimulation, or audio tones, maintaining precise bilateral stimulation while simultaneously monitoring client responses requires sustained attention that can lead to fatigue. This dual-tracking creates a cognitive load that's different from the more conversational flow of traditional therapy. So the question is: How do you structure your practice to account for these demands? Let’s break it down. Redesigning Your Practice Structure Understanding why EMDR work is uniquely demanding leads naturally to the recognition that preventing burnout requires more than just better self-care habits. Unlike other therapeutic approaches, you actually need to structure your practice differently to accommodate the intensive nature of trauma processing work. The best place to start? Caseload composition. Rather than filling your schedule with back-to-back trauma sessions, consider building intentional variety into your week. Some therapists find success with intensive trauma days balanced by lighter consultation or administrative days. Others prefer mixing complex trauma cases with performance work, chronic pain applications, or other EMDR specialties that don't involve processing as many traumatic memories. The goal is creating natural emotional breaks that allow your nervous system to reset between the most demanding sessions. So if you know that certain presentations tend to be more draining (i.e. complex developmental trauma versus single-incident adult trauma) you might strategically space these throughout your schedule rather than clustering them together. Your capacity for holding intense trauma isn't unlimited, so honoring these natural limits actually serves your clients better. The physical setup of your practice space also deserves more attention than many therapists initially realize. EMDR requires:
Investing in ergonomic considerations isn't just about comfort – it's about reducing the physical strain that contributes to daily fatigue and long-term sustainability challenges. Even seemingly small adjustments like scheduling brief movement breaks between sessions can make a big difference. These few minutes allow you to discharge the physical tension that builds up during EMDR work while helping you transition cleanly between clients' emotional content. Session length is another big factor. Most therapists try to squeeze EMDR into standard 50-minute slots, but this can create unnecessary pressure for both you and your client. That’s why many EMDR therapists prefer 75-90 minute sessions. This extra time cuts back on the internal pressure to rush, often making the therapeutic work more effective. If that’s an option for you, it might be worth giving it a try. When you're not watching the clock, both you and your client can engage more fully with whatever emerges during processing. Developing Clinical Approaches That Sustain You While structural changes create the foundation for sustainable practice, how you approach the clinical work itself significantly affects your longevity as an EMDR therapist. Learning to protect your own emotional and physical resources during sessions becomes as important as your technical skills in delivering effective treatment. Many therapists find that the containment and closure techniques they teach clients work equally well for their own regulation. Creating a brief personal protocol for transitioning between sessions (i.e. deep breathing, a moment of bilateral self-stimulation, or brief imagery) helps you discharge emotional residue from one session before beginning the next. Remember too that different types of trauma presentations affect therapists differently, and recognizing your particular sensitivities allows you to structure your caseload thoughtfully. That’s why understanding your own countertransference patterns is important when you're regularly exposed to intense trauma. (Some therapists find that childhood abuse cases affect them more intensely than combat trauma, while others have the opposite experience). There's no right or wrong pattern, but understanding your own responses helps you balance challenging cases with work that feels more manageable. How to Honor Your Limits Perhaps the most challenging aspect of sustainable EMDR practice is learning to recognize and respect your actual capacity (rather than pushing through exhaustion). This requires a fundamental shift in how many therapists think about productivity and professional dedication. There's an important distinction between being physically present for a session and being therapeutically present. When you're running on empty, your clients get a diminished version of you, and of EMDR treatment, which ultimately serves no one well. That’s why learning to recognize when you've reached your capacity for trauma processing on any given day or week is so important. There’s no universal formula, but paying attention to your own patterns allows you to work with your natural rhythms rather than against them:
The key is designing your practice around these patterns rather than fighting them. This might mean scheduling fewer intensive sessions per week, building in recovery time, or accepting that sustainable EMDR work looks different from traditional therapy schedules. What matters is finding an approach that keeps you effective and engaged for the long haul. Question for you: What boundaries have changed your work for the better? What strategies have you developed that help keep you engaged and prevent burnout? I'd love to hear what's made the biggest difference in your ability to maintain effectiveness as an EMDR therapist. Until next week, Chris |
EMDR Therapist Weekly
A weekly dose of insights, tools, and opportunities for EMDR therapists; designed to support your growth, sharpen your practice, and connect you with what's next.
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